Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 109
Filtrar
2.
Acta otorrinolaringol. cir. cuello (En línea) ; 50(1): 69-72, 2022. ilus, graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1363395

RESUMO

La leishmaniasis es una enfermedad protozoaria intracelular. Una de sus formas de presentación es la mucocutánea, que es secuela de la leishmania cutánea y solo se presenta en el 1 % al 5 % de quienes la padecen. Afecta la mucosa nasal, faríngea y laríngea, lo que ocasiona disnea y disfagia. Se presenta el caso de una paciente de 76 años con síntomas obstructivos nasales, en quien se evidenciaron múltiples sinequias nasales y faringolaríngeas. Ante la sospecha clínica de la enfermedad, es importante recordar que el diagnóstico se realiza a través de la intradermorreacción de Montenegro o títulos de inmunofluorescencia indirecta superiores a 1:16, y su tratamiento incluye el antimonio pentavalente, uno de los más utilizados; sin embargo, este tiene alto grado de recurrencias y efectos secundarios, por lo que la anfotericina B se convierte en el tratamiento de elección. En algunos casos, el manejo quirúrgico puede ser de gran utilidad para la mejoría de síntomas y secuelas de la enfermedad. Entonces, la leishmania mucocutánea se convierte en una enfermedad de interés para los otorrinolaringólogos, quienes con el conocimiento de la historia natural de la misma pueden realizar un manejo temprano y la adecuada corrección de secuelas para mejorar la calidad de vida de los pacientes.


Leishmaniasis is an intracellular protozoan disease. One of its forms of presentation is mucocutaneous, which is sequela of cutaneous leishmania and only occurs in 1% to 5% of those who suffer it. It affects the nasal, pharyngeal and laryngeal mucosa, causing dyspnea and dysphagia. We presented a case of a 76-year-old patient with obstructive nasal symptoms, who evidenced multiple nasal and pharyngolaryngeal synechiae. Given the clinical suspicion of the disease, it is important to remember that the diagnosis is made through the Montenegro intradermal reaction and or indirect immunofluorescence titers greater than 1:16, and the treatment includes pentavalent antimonial, one of the most used; however, it has a high degree of recurrence and side effects, so amphotericin B becomes the treatment of choice. In some cases, surgical management can be very useful for the improvement of symptoms caused by the disease. Thus, mucocutaneous leishmania becomes a disease of interest for otorhinolaryngologists, who, with knowledge of its natural history, can carry out early management and adequate correction of sequelae to improve the patients' quality of life.


Assuntos
Humanos , Leishmaniose , Terapêutica , Diagnóstico , Mucosa
3.
J Immunol ; 207(10): 2581-2588, 2021 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-34607939

RESUMO

SARS-CoV-2 is a respiratory pathogen that can cause severe disease in at-risk populations but results in asymptomatic infections or a mild course of disease in the majority of cases. We report the identification of SARS-CoV-2-reactive B cells in human tonsillar tissue obtained from children who were negative for coronavirus disease 2019 prior to the pandemic and the generation of mAbs recognizing the SARS-CoV-2 Spike protein from these B cells. These Abs showed reduced binding to Spike proteins of SARS-CoV-2 variants and did not recognize Spike proteins of endemic coronaviruses, but subsets reacted with commensal microbiota and exhibited SARS-CoV-2-neutralizing potential. Our study demonstrates pre-existing SARS-CoV-2-reactive Abs in various B cell populations in the upper respiratory tract lymphoid tissue that may lead to the rapid engagement of the pathogen and contribute to prevent manifestations of symptomatic or severe disease.


Assuntos
Tonsila Faríngea/imunologia , Subpopulações de Linfócitos B/imunologia , Linfócitos B/imunologia , COVID-19/imunologia , Mucosa/imunologia , Receptores de Antígenos de Linfócitos B/genética , Sistema Respiratório/imunologia , SARS-CoV-2/fisiologia , Anticorpos Antivirais/metabolismo , Criança , Células HEK293 , Humanos , Memória Imunológica , Ativação Linfocitária , Análise de Célula Única , Glicoproteína da Espícula de Coronavírus/imunologia , Transcriptoma
4.
J Infect Dis ; 222(5): 807-819, 2020 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-31740938

RESUMO

BACKGROUND: Increasing evidence supports a critical role of CD8+ T-cell immunity against influenza. Activation of mucosal CD8+ T cells, particularly tissue-resident memory T (TRM) cells recognizing conserved epitopes would mediate rapid and broad protection. Matrix protein 1 (M1) is a well-conserved internal protein. METHODS: We studied the capacity of modified vaccinia Ankara (MVA)-vectored vaccine expressing nucleoprotein (NP) and M1 (MVA-NP+M1) to activate M1-specific CD8+ T-cell response, including TRM cells, in nasopharynx-associated lymphoid tissue from children and adults. RESULTS: After MVA-NP+M1 stimulation, M1 was abundantly expressed in adenotonsillar epithelial cells and B cells. MVA-NP+M1 activated a marked interferon γ-secreting T-cell response to M1 peptides. Using tetramer staining, we showed the vaccine activated a marked increase in M158-66 peptide-specific CD8+ T cells in tonsillar mononuclear cells of HLA-matched individuals. We also demonstrated MVA-NP+M1 activated a substantial increase in TRM cells exhibiting effector memory T-cell phenotype. On recall antigen recognition, M1-specific T cells rapidly undergo cytotoxic degranulation, release granzyme B and proinflammatory cytokines, leading to target cell killing. CONCLUSIONS: MVA-NP+M1 elicits a substantial M1-specific T-cell response, including TRM cells, in nasopharynx-associated lymphoid tissue, demonstrating its strong capacity to expand memory T-cell pool exhibiting effector memory T-cell phenotype, therefore offering great potential for rapid and broad protection against influenza reinfection.


Assuntos
Linfócitos T CD8-Positivos/imunologia , Vírus da Influenza A Subtipo H3N2/imunologia , Proteínas do Nucleocapsídeo/imunologia , Proteínas da Matriz Viral/imunologia , Vacinas Virais/imunologia , Tonsila Faríngea/citologia , Tonsila Faríngea/imunologia , Adolescente , Adulto , Linfócitos T CD8-Positivos/metabolismo , Linfócitos T CD8-Positivos/fisiologia , Degranulação Celular , Proliferação de Células , Células Cultivadas , Criança , Pré-Escolar , Granzimas/metabolismo , Humanos , Imunidade Celular , Memória Imunológica , Interferon gama/metabolismo , Ativação Linfocitária , Proteína 1 de Membrana Associada ao Lisossomo/metabolismo , Nasofaringe , Tonsila Palatina/citologia , Tonsila Palatina/imunologia , Mucosa Respiratória/imunologia , Vacinas de DNA , Adulto Jovem
5.
Int J Pediatr Otorhinolaryngol ; 124: 116-119, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31176025

RESUMO

INTRODUCTION: Otitis media with effusion is common middle ear mucosa disease that can cause hearing loss in children. Adenoid hypertrophy can cause recurrent acute otitis media in addition to otitis media with effusion as a result of eustachian tube dysfunction and primary infection focus. The aim of this study was to investigate the effect of adenoid hypertrophy on the hearing threshold in children suffering from otitis media with effusion. METHODS: Children of school age with otitis media with effusion were included in the study. The size and location of the adenoid tissue were determined by examination with a flexible endoscope. Four adenoid size groups were determined according to the percentage of choanal closure. The coverage was 0-25% in the first group, 26-50% in the second group, 51-75% in the third group and 76-100% in the 4th group. The location of the adenoid tissue in the nasopharynx was divided into three groups. In group A, the adenoid tissue was not in contact with torus tubarius. In group B, the adenoid tissue was in contact with the torus tubarius but did not cover it. In group C, the adenoid tissue covered the torus tubarius completely. Bone and air conduction thresholds were determined using standard procedures. The statistical relationship between the size and location of adenoid tissue and the hearing thresholds was investigated. RESULTS: The study was conducted with the 88 ears of 50 children aged 5-15 years. The median values of mean air conduction thresholds at 500 Hz, 1000 Hz, and 2000 Hz in the adenoid tissue size groups 1-4 were 22 dB HL, 20 dB HL, 15 dB HL, and 20 dB HL respectively. The median values of the mean air conduction thresholds were 20 dB HL, 20 dBHL and 18 dB HL in the adenoid location group A-C, respectively. No significant correlation was found between the groups (p:0.213) and the relevant hearing values (p:0.670). Type B tympanogram was identified in 46 ears and type C tympanogram in 42 ears. The mean hearing thresholds were significantly higher in the ears with a type B tympanogram in the otitis media with effusion cases. (P < 0.001).There was no significant correlation between the duration of effusion and the adenoid size (p:0.931), adenoid location (p:0.626) and hearing threshold (p:0.815). CONCLUSION: We concluded that adenoid tissue size and location have no effect on hearing thresholds and the duration of effusion in otitis media with effusion. We suggest caution before deciding on adenoidectomy in otitis media with effusion cases. Adenoidectomy should not be performed in children over 4 years of age unless there is a definite indication such as nasal obstruction or chronic adenitis.


Assuntos
Tonsila Faríngea/patologia , Limiar Auditivo , Otite Média com Derrame/etiologia , Otite Média com Derrame/fisiopatologia , Tonsila Faríngea/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Endoscopia , Feminino , Audição , Testes Auditivos , Humanos , Hipertrofia/complicações , Hipertrofia/fisiopatologia , Masculino , Nasofaringe/patologia , Tamanho do Órgão , Membrana Timpânica/fisiopatologia
6.
Med. interna (Caracas) ; 33(3): 185-194, 2017. ilus, tab
Artigo em Espanhol | LIVECS, LILACS | ID: biblio-1009127

RESUMO

La difteria es una enfermedad prevenible por vacunas. En la actualidad existe un brote en nuestro país que se inició en abril de 2016. Desde entonces se han descrito casos en diferentes sitios del país predominantemente de la forma faríngea. La difteria cutánea no ha sido reportada en este brote. A nivel mundial el compromiso simultáneo en piel y mucosas, no ha sido descrito. La paciente cuya enfermedad describimos aquí es un caso de difteria de presentación atípica que se inicia con expresión cutánea y evoluciona a compromiso nasal, ocular y faríngeo con complicaciones severas en la órbita ocular expresadas como un síndrome del vértex orbitario, en una paciente con diabetes mellitus tipo 2 no controlada, que tuvo una evolución tórpida que la llevó a la muerte. Se revisa la literatura(AU)


Diphtheria is a vaccine-preventable disease. Actually, there is an outbreak in Venezuela since April 2016. Cases in different parts of the country have been described, predominantly pharyngeal. Cutaneous diphtheria has not been reported in this outbreak. The simultaneous presentation of the cutaneous form with mucosal involvement has not been described in the revised literature. We present a case of diphtheria with atypical presentation that begins with cutaneous expression and evolves to nasal, ocular and pharyngeal compromise with severe complications of the orbit, expressed in an orbital vertex syndrome in a patient with type 2 diabetes mellitus, who had a torpid evolution that led her to death. The literature is reviewed(AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Corynebacterium diphtheriae/patogenicidade , Difteria/patologia , Mucosa , Doenças Transmissíveis , Medicina Interna
7.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-150397

RESUMO

OBJECTIVES: Surgical management of children with chronic otitis media with effusion (OME) includes tympanostomy tube insertion or adenoidectomy, alone or with myringotomy and tube insertion. The aim of this study was to compare the effectiveness of transoral microdebrider endoscopic-assisted adenoidectomy (TOMEA) and traditional adenoidectomy in the management of children with mild hearing loss due to OME and chronic adenoiditis. METHODS: This prospective, double-blind and controlled study involved 120 consecutive patients aged 4-12 years, who were randomised 1:1 to undergo TOMEA or traditional adenoidectomy under general anesthesia. All the patients underwent a complete otolaryngological examination, including nasopharyngeal fibre endoscopy (NFE), pneumatic otoscopy, otomicroscopy, tympanometry and supraliminar tonal audiometry, upon enrolment, and three and nine months postoperatively. RESULTS: There were no statistically significant differences in age or gender distribution between the TOMEA group (mean age, 4.9±1.1 years; 53.3% males) and the traditional adenoidectomy group (mean age, 5.3±0.9 years; 56.7% males). Both procedures led to a significant improvement in choanal patency (P<0.01) and all of the otological and audiological parameters (P<0.01) 3 and 9 months postoperatively, although postoperative NFE showed that the mean percentage of residual choanal obstruction was significantly less in the TOMEA group (P=0.02). There was no significant between-group difference in the percentage of children with tympanic membrane changes, but the postoperative prevalence of children with a type B tympanogram was significantly lower in the TOMEA group after 3 (15.0% vs. 31.7%, P=0.05) and 9 months (18.3% vs. 38.3%, P=0.02), as was the percentage of children with mild conductive hearing loss (3.3% vs. 23.3%, P<0.01; and 8.3% vs. 28.3%, P<0.01). CONCLUSION: Although both TOMEA and traditional adenoidectomy are effective in treating children with mild hearing loss due to adenoidal hypertrophy and OME, the former achieves the greater reduction in residual adenoidal hypertrophy and better audiological outcomes.


Assuntos
Criança , Humanos , Testes de Impedância Acústica , Adenoidectomia , Tonsila Faríngea , Anestesia Geral , Audiometria , Endoscopia , Perda Auditiva , Perda Auditiva Condutiva , Audição , Hipertrofia , Ventilação da Orelha Média , Otite Média com Derrame , Otite Média , Otite , Otoscopia , Prevalência , Estudos Prospectivos , Membrana Timpânica
8.
Int J Pediatr Otorhinolaryngol ; 79(9): 1444-7, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26169069

RESUMO

OBJECTIVES: The aim of this study was to evaluate the effect of adenotonsillectomy on immediate Eustachian tube (E-tube) function in children with adenotonsillar hypertrophy. METHODS: All children who were scheduled to undergo adenotonsillectomy were assessed. Physical examinations were performed on the preoperative day, and on postoperative days 1 and 2. Exams included visual inspection of the tympanic membrane and tympanometry including measurement of middle ear pressure (MEP) (daPa). The children were divided into four types (AA, CA, CC, and BB types) based on the tympanometric results of postoperative days 1 and 2. RESULTS: A total of 50 ears from 25 children (mean age±standard deviation [SD]=8.6±3.2; male/female=10/15; mean body mass index±SD [kg/m(2)]=18.5±3.7) were included. The rates of AA, CA, CC, and BB types were 10% (5/50), 14% (7/50), 74% (37/50), and 2% (1/50), respectively. On postoperative day 2, 76% of cases were abnormal or unresolved (38/50), while 24% were normal or resolved (12/50). There were significant decreases in MEP both before and after adenotonsillectomy (p's<0.001). However, there were no significant differences in the MEPs measured on postoperative days 1 and 2. There were no significant differences between the right and left ears with regard to the MEPs on the preoperative day, or postoperative days 1 and 2. CONCLUSIONS: Immediate E-tube dysfunction is a relatively common complication in children after adenotonsillectomy. Therefore, in the setting of immediate E-tube dysfunction, it is important to properly plan postoperative care and management.


Assuntos
Adenoidectomia/efeitos adversos , Tuba Auditiva/fisiopatologia , Tonsilectomia/efeitos adversos , Testes de Impedância Acústica , Tonsila Faríngea/patologia , Tonsila Faríngea/cirurgia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Hipertrofia/cirurgia , Masculino , Tonsila Palatina/patologia , Tonsila Palatina/cirurgia , Período Pós-Operatório , Pressão , Membrana Timpânica/cirurgia
9.
Artigo em Chinês | MEDLINE | ID: mdl-26103659

RESUMO

OBJECTIVE: To observe the clinical effect of endoscope-guided low temperature plasma ablateing adenoidectomy with tympanic membrane incision drainage and tympanic membrane indwelling catheter to treat secretory otitis media of children. METHOD: Fifty-two cases (98 ears) of secretory otitis media in children with adenoid hypertrophy were treated. Respectively endoscope-guided tympanic membrane incision drainage parallel low temperature plasma ablateing adenoidectomy and endoscope-guided tympanic membrane indwelling catheter parallel low temperature plasma ablateing adenoidectomy. RESULT: In group A, 30 cases of 58 ears, cure 36 ears, improving 14 ears, invalid 8 ears, the effective rate was 86.2%. In group B, 22 cases of 40 ears, cured 32 ears, improvement in 6 ears, invalid 2 ears, the effective rate was 95.0%. According to statistical analysis of curative effect, there was no significant difference by effective rate between two groups. CONCLUSION: For the patients with secretory otitis media caused by adenoidal hypertrophy, the endoscope-guided tympanic membrane incision drainage parallel low temperature plasma ablateing adenoidectomy can be regarded as a kind of method to reduce the risk of tympanic membrane perforation.


Assuntos
Adenoidectomia/métodos , Cateteres de Demora , Ventilação da Orelha Média/métodos , Otite Média com Derrame/cirurgia , Tonsila Faríngea/patologia , Criança , Temperatura Baixa , Humanos , Perfuração da Membrana Timpânica
10.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-747807

RESUMO

OBJECTIVE@#To observe the clinical effect of endoscope-guided low temperature plasma ablateing adenoidectomy with tympanic membrane incision drainage and tympanic membrane indwelling catheter to treat secretory otitis media of children.@*METHOD@#Fifty-two cases (98 ears) of secretory otitis media in children with adenoid hypertrophy were treated. Respectively endoscope-guided tympanic membrane incision drainage parallel low temperature plasma ablateing adenoidectomy and endoscope-guided tympanic membrane indwelling catheter parallel low temperature plasma ablateing adenoidectomy.@*RESULT@#In group A, 30 cases of 58 ears, cure 36 ears, improving 14 ears, invalid 8 ears, the effective rate was 86.2%. In group B, 22 cases of 40 ears, cured 32 ears, improvement in 6 ears, invalid 2 ears, the effective rate was 95.0%. According to statistical analysis of curative effect, there was no significant difference by effective rate between two groups.@*CONCLUSION@#For the patients with secretory otitis media caused by adenoidal hypertrophy, the endoscope-guided tympanic membrane incision drainage parallel low temperature plasma ablateing adenoidectomy can be regarded as a kind of method to reduce the risk of tympanic membrane perforation.


Assuntos
Criança , Humanos , Adenoidectomia , Métodos , Tonsila Faríngea , Patologia , Cateteres de Demora , Temperatura Baixa , Ventilação da Orelha Média , Métodos , Otite Média com Derrame , Cirurgia Geral , Perfuração da Membrana Timpânica
11.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-24029

RESUMO

BACKGROUND: Cytologic diagnosis of pulmonary adenoid cystic carcinoma (AdCC) is frequently challenging and differential diagnosis with small cell carcinoma is often difficult. METHODS: Eleven cytologically diagnosed cases of pulmonary AdCC were collected and reviewed according to fifteen cytomorphologic characteristics: small cell size, cellular uniformity, coarse chromatin, hyperchromasia, distinct nucleolus, frequent nuclear molding, granular cytoplasm, organoid cluster, sheet formation, irregular border of cluster, hyaline globule, hyaline basement membrane material, individual cell necrosis or apoptotic body, and necrotic background. Twenty cases of small cell carcinoma and fifteen cases of non-pulmonary AdCC were also reviewed for the comparison. RESULTS: Statistically significant differences were identified between pulmonary AdCC and small cell carcinoma in fourteen of the fifteen cytomorphologic criteria (differences in sheet formation were not statistically significant). Cellular uniformity, distinct nucleolus, granular cytoplasm, distinct cell border, organoid cluster, hyaline globule, and hyaline basement membrane material were characteristic features of AdCC. Frequent nuclear molding, individual cell necrosis, and necrotic background were almost exclusively identified in small cell carcinoma. Although coarse chromatin and irregular cluster border were observed in both, they favored the diagnosis of small cell carcinoma. Hyaline globules were more frequently seen in non-pulmonary AdCC cases. CONCLUSIONS: Using the fifteen cytomorphologic criteria described by this study, pulmonary AdCC could be successfully distinguished from small cell carcinoma. Such a comprehensive approach to an individual case is recommended for the cytologic diagnosis of pulmonary AdCC.


Assuntos
Tonsila Faríngea , Citotoxicidade Celular Dependente de Anticorpos , Membrana Basal , Carcinoma Adenoide Cístico , Carcinoma de Células Pequenas , Tamanho Celular , Cromatina , Citoplasma , Diagnóstico , Diagnóstico Diferencial , Fungos , Hialina , Pulmão , Necrose , Organoides
12.
Int. j. morphol ; 32(4): 1341-1346, Dec. 2014. ilus
Artigo em Inglês | LILACS | ID: lil-734681

RESUMO

We studied the gill epithelium of juveniles of Odontesthes bonariensis using scanning electron microscopy with a particular interest in the relationship between cell morphology and the different functional aspects of gills. The specimens used were collected in Laguna de los Padres, Buenos Aires Province, Argentina. The gill filaments or primary lamellae are arranged in two rows along the convex outer face of the gill arch forming the anterior and posterior hemibranchiae. On its concave inner face, each arch supports two rows of gill rakers forming the pharyngeal region wall. The primary lamellae are lined by a stratified epithelium made up of polygonal cells with well-defined outlines and cell membrane microfolds. Several mucous and chloride cells were observed in the primary lamellae. The epithelial cells of the secondary lamellae have ill-defined outlines and few microfolds. Both the arches and gill rakers are covered by a stratified epithelium of polygonal cells, among which mucous cells and taste corpuscles are abundant. The ultrastructural analysis of gills of O. bonariensis contributes to the advancement of knowledge of the organ histophysiology and of future histopathological studies.


Se estudió el epitelio branquial de juveniles de Odontesthes bonariensis utilizando microscopía electrónica de barrido con un interés particular en la relación entre la morfología celular y los distintos aspectos funcionales de las branquias. Los ejemplares utilizados fueron colectados en la Laguna de los Padres, Provincia de Buenos Aires, Argentina. Los filamentos branquiales o laminillas primarias están dispuestos en dos filas a lo largo de la cara exterior convexa del arco branquial formando las hemibranquias anterior y posterior. En su cara interior cóncava, cada arco sostiene dos hileras de branquiespinas que forman la pared de la región faríngea. Las laminillas primarias están revestidas por un epitelio estratificado constituido por células poligonales con contornos bien definidos y micropliegues de la membrana celular. Se observaron numerosas células clorhídricas y mucosas en las laminillas primarias. Las células epiteliales de las laminillas secundarias tienen contornos poco definidos y escasos micropliegues. Tanto los arcos como las branquiespinas están cubiertos por un epitelio estratificado de células poligonales, entre las cuales hay abundantes células mucosas y corpúsculos gustativos. El análisis ultraestructural de las branquias de O. bonariensis proporciona información para avanzar en el conocimiento de la histofisiología del órgano y para realizar futuros estudios histopatológicos.


Assuntos
Animais , Microscopia Eletrônica de Varredura , Peixes/anatomia & histologia , Brânquias/ultraestrutura , Smegmamorpha
13.
Ann Allergy Asthma Immunol ; 110(3): 178-83, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23548528

RESUMO

BACKGROUND: Human ß-defensins (HBDs) are a newly identified family of antimicrobial peptides that are expressed by epithelia on mucosal surfaces. Exposure of airway epithelial cells to TH2-type cytokines results in a significant decrease in the antimicrobial activity of the cells. OBJECTIVE: To investigate the effect of allergic rhinitis on the expression of HBD-2 in tonsils and adenoids. METHODS: Palatine tonsils and adenoids were obtained from 30 patients with no history of recurrent tonsillitis. The patients were divided into 2 groups: allergic rhinitis and nonallergic rhinitis groups. Real-time polymerase chain reaction analysis was used to measure messenger RNA (mRNA) levels of HBD-2 mRNA in tonsil and adenoid tissue samples from the 2 patient groups. Immunofluorescent staining and enzyme-linked immunosorbent assay (ELISA) were used to evaluate the expression of HBD-2 protein in tonsil and adenoid tissues. The concentration of the cytokines interleukin (IL) 4, IL-5, and interferon γ (IFN-γ) in tissue homogenates was measured by ELISA. RESULTS: Immunofluorescent staining data demonstrated the expression of HBD-2 protein in the surface epithelia of tonsils, and a marked difference in the staining intensity was observed the between 2 groups. HBD-2 mRNA and protein levels in the tonsils were significantly lower in the allergic rhinitis group than that in the nonallergic rhinitis group (P = .03 and P = .04, respectively). IL-5 and IFN-γ were not detected, and no significant difference was found in IL-4 concentrations in tonsil homogenates between the 2 groups. CONCLUSION: Allergic rhinitis suppresses HBD-2, an epithelial antimicrobial peptide, in the tonsils.


Assuntos
Tonsila Faríngea/imunologia , Tonsila Palatina/imunologia , Rinite Alérgica Perene/imunologia , beta-Defensinas/metabolismo , Adolescente , Células Cultivadas , Criança , Pré-Escolar , Citocinas/genética , Citocinas/metabolismo , Ensaio de Imunoadsorção Enzimática , Feminino , Regulação da Expressão Gênica/imunologia , Humanos , Masculino , Mucosa/imunologia , Mucosa Respiratória/imunologia , Rinite Alérgica , Equilíbrio Th1-Th2
14.
Rio de Janeiro; s.n; 2012. xvii,70 p. tab, ilus.
Tese em Português | LILACS | ID: lil-734206

RESUMO

Em aproximadamente 90 por cento das lesões mucosas de LTA o nariz é o único sítio envolvido. As orelhas normalmente não são envolvidas na leishmaniose mucosa, embora o envolvimento mucoso da nasofaringe possa afetar o orifício da tuba de Eustáquio provocando o aparecimento de otite média com efusão nas formas mais avançadas de leishmaniose mucosa. Caso a otite média não seja identificada e conduzida de forma adequada, o paciente pode ficar com seqüelas otológicas e audiológicas de difícil recuperação. Este estudo objetivou avaliar as funções da orelha média dos pacientes com forma mucosa de LTA para verificar a freqüência de disfunção tubária/otite média com efusão e descrever os fatores a elas associadas. Foi realizado um estudo prospectivo e longitudinal nos pacientes com Leishmaniose Mucosa ou Cutâneo-mucosa, atendidos no Instituto de Pesquisa Clínica Evandro Chagas na Fundação Oswaldo Cruz, a partir de 2008. Os pacientes foram submetidos às avaliações otorrinolaringológica e fonoaudiológica nas consultas prétratamento e até um mês após a conclusão do tratamento ou até a normalização das alterações, composta de: questionário de avaliação de alterações auditivas e de queixas otorrinolaringológicas; avaliação endoscópica das mucosas laríngea, faríngea, oral e nasal; avaliação otoscópica; audiometria tonal, audiometria vocal, impedanciometria. Foram descritas as freqüências simples das variáveis categóricas e as medidas de tendência central e dispersão das variáveis quantitativas contínuas...


As freqüências de otite média foram comparadas entre as diferentes localizações de lesões mucosas por LTA por teste para proporção do tipo qui-quadrado. Foram incluídos 17 pacientes, sendo 15 do sexo masculino (88,2 por cento) e dois do sexo feminino (11,8 por cento). A idade variou de 30 a 77 anos, com média de 52,7 anos. Quatro pacientes (23,5 por cento) apresentaram curva B ou C no exame imitânciométrico, sendo que destes, dois (11,8 por cento) apresentavam retração de membrana timpânica e um (5,9 por cento) curva audiométrica do tipo condutiva. No pós-tratamento, dos quatro pacientes com alteração de orelha média no pré-tratamento, um manteve curva C (25 por cento), dois normalizaram e um não teve seu último exame realizado, porém apresentava normalização do padrão condutivo de sua audiometria. A ausência de alteração da tuba auditiva em 75 por cento dos casos nos alerta para que outros mecanismos que não o obstrutivo pelo processo inflamatório da LTA estejam envolvidos na etiopatogenia da OME decorrente da LM. Estes resultados tornam visíveis a importância da realização de avaliação otoscópica e de exames audiométricos e imitanciométricos antes e após o tratamento de pacientes com leishmaniose mucosa...


Assuntos
Humanos , Tuba Auditiva , Leishmaniose , Otite Média
15.
J Laryngol Otol ; 125(3): 274-8, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21205368

RESUMO

OBJECTIVE: To determine whether tympanostomy tube insertion has benefit, compared with simple myringotomy, in children with otitis media with effusion who receive concurrent adenoidectomy as treatment for obstructive sleep apnoea syndrome caused by adenoid hypertrophy. METHODS: Fifty-two children older than three years with obstructive sleep apnoea syndrome were randomly assigned to receive either adenoidectomy plus tympanostomy tube insertion (group one, n = 25) or adenoidectomy plus myringotomy (group two, n = 27). Pre- and post-operative health-related quality of life was assessed using the otitis media-6 (OM-6) tool, and audiological outcomes were recorded six and 12 months post-operatively. RESULTS: Group one showed better quality of life scores six months post-operatively (score difference -0.38, confidence interval -0.65 to -0.10) but not 12 months post-operatively (score difference -0.23, confidence interval -0.76 to 0.11), compared with pre-operative values. Audiological outcomes did not differ significantly at either time point, compared with pre-operative values. CONCLUSION: Tympanostomy tube insertion confers a short term benefit, compared with simple myringotomy, in children older than three years with otitis media with effusion who receive concurrent adenoidectomy as treatment for obstructive sleep apnoea syndrome. Further studies are necessary to identify which of these children will receive long-lasting benefit from tympanostomy tube insertion.


Assuntos
Adenoidectomia , Tonsila Faríngea/patologia , Ventilação da Orelha Média , Otite Média com Derrame/cirurgia , Apneia Obstrutiva do Sono/cirurgia , Tonsila Faríngea/cirurgia , Audiometria de Tons Puros , Criança , Pré-Escolar , Feminino , Humanos , Hipertrofia/complicações , Masculino , Otite Média com Derrame/complicações , Estudos Prospectivos , Qualidade de Vida , Recidiva , Estações do Ano , Apneia Obstrutiva do Sono/complicações , Resultado do Tratamento , Membrana Timpânica/cirurgia
16.
Int J Pediatr Otorhinolaryngol ; 75(1): 85-8, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21112097

RESUMO

OBJECTIVES: To investigate age of diagnosis, typical symptoms, finding of the palate, therapy options and accompanying diseases. METHODS: A retrospective analysis of 439 patients with symptomatic submucous cleft palate (SMCP), who received a veloplasty operation (butterfly suture technique developed by Haase) was made. RESULTS: SMCP was initially diagnosed at the mean age of 4.9 years. Main symptoms were hyper nasal speech (51%) and conductive hearing loss (45%), which resolved after veloplasty (often in combination with adenotomy and insertion of ventilation tubes). Typical findings of the palate were a lack of posterior nasal spine (68%) and bifid uvula (59%). Following surgery 17.1% required speech therapy and 5.5% needed velopharyngoplasty due to continuing hyper nasal speech. CONCLUSION: SMCP is often diagnosed very late, though symptoms of velopharyngeal insufficiency (hyper nasal speech, Eustachian tube dysfunction) and bifid uvula are present. We therefore recommend that all patients with such findings are examined by an appropriate specialist such as Phoniatrics, Otolaryngologist and Oral-Maxillofacial-Surgeon so that early diagnosis and palatoplasty can be performed. The veloplasty operation (butterfly suture technique) can be recommended as a safe therapy for velopharyngeal insufficiency for patients with symptomatic SMCP.


Assuntos
Fissura Palatina/diagnóstico , Fissura Palatina/cirurgia , Insuficiência Velofaríngea/terapia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Seguimentos , Humanos , Lactente , Laringoplastia/efeitos adversos , Laringoplastia/métodos , Masculino , Mucosa/patologia , Mucosa/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos/efeitos adversos , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Palato Mole/anormalidades , Palato Mole/cirurgia , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/cirurgia , Recuperação de Função Fisiológica , Reoperação , Estudos Retrospectivos , Fonoterapia/métodos , Técnicas de Sutura , Resultado do Tratamento , Insuficiência Velofaríngea/diagnóstico , Insuficiência Velofaríngea/etiologia
17.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wpr-65207

RESUMO

The uvulopalatal flap (UPF) technique is a modification of uvulopalatopharyngoplasty (UPPP) for the surgical treatment of obstructive sleep apnea. In the UPF technique, an uvulopalatal flap is fabricated and sutured to the residual mucosa of the soft palate to expand the antero-posterior dimensions of the oropharyngeal inlet. In the extended uvulopalatal flap (EUPF) technique, an incision at the tonsillar fossa is added to the classical UPF technique followed by the removal of mucosa and submucosal adipose tissue for additional expansion of the lateral dimension. The EUPF technique is more conservative and reversible than UPPP. Therefore, complications, such as velopharyngeal insufficiency, dysphagia, dryness, nasopharyngeal stenosis and postoperative pain, are reduced. In the following case report, the patient was diagnosed with obstructive sleep apnea and treated with the EUPF technique. The patient's total respiratory disturbance events per hour (RDI) was decreased to 15.4, the O2 saturation during the sleep was increased, and the excessive daytime sleepiness had disappeared after the surgery without complications. The authors report this case with a review of the relevant literature.


Assuntos
Humanos , Tecido Adiposo , Baías , Constrição Patológica , Transtornos de Deglutição , Mucosa , Dor Pós-Operatória , Palato Mole , Apneia Obstrutiva do Sono , Retalhos Cirúrgicos , Resultado do Tratamento , Úvula , Insuficiência Velofaríngea
18.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-205388

RESUMO

OBJECTIVES: The objective of this study was to determine the various factors that affect the extrusion rate of ventilation tubes (VTs), including the nature of the middle ear effusion. METHODS: A retrospective chart review of 82 pediatric patients (177 ears) who received VT insertion surgery under general anesthesia was carried out to evaluate the relationship between various factors and the VT extrusion rate. The factors we analyzed included age, gender, the adenoid size, the amount and content of the middle ear effusion after myringotomy, bleeding events, associated adenoidectomy and the findings of the tympanic membrane status, the tympanometry and the audiometry of the air bone gap. RESULTS: The mean extrusion time was 254 days (range, 11 to 809 days). The patients with no history of previous VT insertion had a longer extrusion time (mean, 279 days) than did the patients who had undergone previous VT insertion (mean, 203 days). The patients with serous effusion had the shortest extrusion time (mean, 190 days) as compared to those patients with glue (273 days) and pus (295 days) effusions. Other factors had no statistical significant relationship with the extrusion time. CONCLUSION: The mean VT extrusion time was 254 days. The VT extrusion time was significantly related to the characteristics of the middle ear effusion and a history of previous VT insertion. Thus, the nature of middle ear effusion can provide a clinical clue to predict the VT extrusion time.


Assuntos
Humanos , Testes de Impedância Acústica , Adenoidectomia , Tonsila Faríngea , Adesivos , Anestesia Geral , Audiometria , Hemorragia , Otite Média com Derrame , Estudos Retrospectivos , Supuração , Membrana Timpânica , Ventilação
19.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wpr-644875

RESUMO

BACKGROUND AND OBJECTIVES: Immunoglobulin E (IgE) production in adenoid has been debated and the role of adenoid in development of allergy remains largely unknown. To examine the production of local IgE in adenoid involved with IgE-mediated sensitization, we evaluated IgE production and the expression of the transcription factor B cell leukemia/lymphoma-6 (BCL-6) and B lymphocyte inducer of maturation program 1 (Blimp-1) in adenoids. SUBJECTS AND METHOD: Ten children with allergic rhinitis (AR) and ten children without any history of AR were enrolled. Immunohistochemical studies of adenoid for IgE, BCL-6 and Blimp-1 were performed. RESULTS: IgE was stained mainly in the germinal center and submucosal area and the stainingscores of antibody to IgE did not differ signigicantly between children with AR and control. BCL- 6 was mainly stained in mucosa and germinal center and Blimp-1 in mucosa. The scores of antibody to BCL-6 and Blimp-1 in children with AR and control did not show significant differences. CONCLUSION: We found that allergic rhinitis was not involved in the production of IgE nor the expression of the transcription factor BCL-6 and Blimp-1 in adenoid


Assuntos
Criança , Humanos , Tonsila Faríngea , Centro Germinativo , Hipersensibilidade , Imunoglobulina E , Imunoglobulinas , Linfócitos , Mucosa , Rinite , Rinite Alérgica Perene , Fatores de Transcrição
20.
J Mol Histol ; 39(3): 265-73, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18246436

RESUMO

The human adenoid epithelium forms a continuous barrier against a wide variety of exogenous antigens. In this study, to elucidate the structures of the epithelial barrier in the human adenoid, including M-cells, we identified M-cells using an anti-cytokeratin 20 (Ck20) antibody and investigated expression of tight junction proteins in human adenoid epithelium in vivo and in vitro. In human adenoid epithelium and primary cultures, mRNAs of occludin, junctional adhesion molecule-A, ZO-1, and claudin-1, -4, -7, and -8 were detected by reverse transcription-polymerase chain reaction, whereas claudin-2 and -9 were expressed in vitro. In the epithelium in vivo, some Ck20-positive cells were randomly observed and indicated pocket-like structures, whereas Ck7 was positive in almost cells. Transmission electron microscopy revealed that Ck20-associated gold particles could be identified in M-like cells which had short microvilli and harboured the lymphocyte in the pocket-like structure. In primary cultures in vitro, Ck20-positive cells were also detected and had a function to take up fluorescent microparticles. In Ck20-positive cells in vivo and in vitro, expression of occludin, ZO-1, claudin-1 and -7 were observed at cell borders. These results indicate that the epithelial barrier of the human adenoid is stably maintained by expression of tight junction proteins in the epithelium including Ck20-positive M-like cells.


Assuntos
Tonsila Faríngea/citologia , Tonsila Faríngea/metabolismo , Epitélio/metabolismo , Queratina-20/metabolismo , Proteínas de Membrana/metabolismo , Junções Íntimas/metabolismo , Tonsila Faríngea/ultraestrutura , Células Cultivadas , Criança , Pré-Escolar , Células Epiteliais/metabolismo , Células Epiteliais/ultraestrutura , Epitélio/ultraestrutura , Regulação da Expressão Gênica , Humanos , Proteínas de Membrana/genética , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Junções Íntimas/ultraestrutura
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...